Curbing use in elderly may be controversial but wise, experts say
TUESDAY, July 28 (HealthDay News) -- Antiviral drug treatment of swine flu may be wasted on the elderly and should be reserved for young people, suggest researchers who created a model of the effect of antiviral treatment on the spread of the H1N1 virus.
If the current swine flu pandemic behaves like the 1918 flu, antiviral drugs would not significantly reduce death rates among people older than 65 and, in fact, might cause the H1N1 virus to develop increased drug resistance, according to Stefano Merler, of the Bruno Kessler Foundation in Italy, and his colleagues.
Their report appears online in BMC Infectious Diseases.
"Although it is too early to confidently predict some important features of the ongoing influenza pandemic, the use of antivirals is confirmed to be the most effective single intervention, in the absence of vaccines," Merler said in a news release from the journal's publisher. "It requires, however, a very large stockpile of antiviral drugs. Our work demonstrates that, even in countries where the antiviral stockpile is not sufficient to treat 25 percent of the population, the minimum level suggested by [the World Health Organization], it is possible to reduce morbidity and excess mortality by prioritizing the use of antivirals by age."
"Although a policy of age-specific prioritization of antiviral use will be controversial ethically, it may be the most efficient use of stockpiled therapies," he said. "This is of particular importance for countries where the amount of drug stockpiled is well below the WHO's suggested level."
The researchers concluded that developing early estimates of the impact of the swine flu pandemic and of age-specific death rates could prove important in optimizing the use of antiviral drugs during the pandemic.
The U.S. Centers for Disease Co
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